参麦注射液对呼吸衰竭患儿膈肌疲劳的影响

目的：探讨参麦注射液对呼吸衰竭患儿膈肌疲劳的影响。方法：35例呼吸衰竭伴有膈肌疲劳的住院患儿，随机分为参麦注射液组（A组）和对照组（B组）。B组采用抗感染、吸氧和静脉营养等综合治疗；A组在B组治疗基础上加用参麦注射液静脉注射。运用电阻抗呼吸图作为疗效标准，观察药物使用后30min有效例数、膈肌疲劳消失所需的时间及治疗前后动脉血气分析有关指标的变化。结果：（1）在30min内，A组有效例数（15／18）明显高于B组(4/17),差异有显著性（P＜0．01）；（2）两种治疗方法均能增加pH，降低PaCO2。在降低PaCO2时，A组同B组比较差异有显著性（P＜0．05）。另外，A组患儿膈肌疲劳消失所需时间比B组患儿短（P＜0．01）。结论：参麦注射液是一种有效的治疗儿童膈肌疲劳的药物，且副作用小，值得临床推广。

Effect of Shenmai Injection on Diaphragmatic Fatigue in Children with Respiratory Failure

Objective: To study the effect of Shenmai injection (SMI) on diaphragmatic fatigue in children with respiratory failure. Methods: Thirty five cases of children respiratory failure with diaphragmatic fatigue were divided into two groups. The control group was treated with comprehensive therapy including anti infection, oxygen inhalation and parenteral nutrition, etc. The SMI group was treated with SMI intravenously, besides the comprehensive therapy as in the control group. Taking electrical impedance respirogram (IRG) as criterion of therapeutic effect, the effective cases after 30 min medication, time for diaphragmatic fatigue disappearance, as well as arterial blood gas analysis before and after treatment were analyzed. Results: (1) In 30 min after medication, the effective cases in the SMI group (15/18) were more than that in the control group (4/17,P<0 01); (2)Blood pH increased and PaCO 2 decreased in both groups after treatment, but the decrease of PaCO 2 was more significant in the SMI group (P<0 05); (3) Time of diaphragmatic fatigue disappearance in the SMI group was shorter than that in the control group (P<0 01). Conclusion: SMI is an effective drug for treatment of diaphragmatic fatigue in children with less adverse effect, and worthwhile for spreading in clinical practice.